بسم هللا الرحمن الرحيم ﴿و ما أوتيتم من العلم إال قليال﴾ صدق هللا العظيم االسراء اية 58 Physiology of Digestion and Absorption By Dr. Abdel-aziz M. Hussein Lecturer of Medical Physiology Overview of the Digestive System The Digestive System Consists of ; a) Long hollow muscular tube or canal or tract called gastrointestinal tract or (GIT): it is about 5 meters long b) Accessory glands: include: • Salivary glands • Liver and gall bladder • Pancreas Overview of the Digestive Tract GIT consists of; • • • • • • • • Oral cavity or mouth Pharynx Esophagus Stomach Small intestine Large intestine Rectum Anus Components of Digestive System and Their Functions Main Functions of Digestive System • 4 major activities of GI tract 1. Motility • Propel ingested food from mouth toward rectum 2. Secretion of juices e.g. saliva • Aid in digestion and absorption 3. Digestion • Food broken down into absorbable molecules 4. Absorption • Nutrients, electrolytes, and water are absorbed or transported from lumen of GIT to blood stream Motor Functions (Motility) of GIT Motility of the GIT 1. Motility in the mouth 2 types; a) Chewing is important because -The food is lubricated by being mixed with saliva -The food is exposed to salivary amylase enzyme, which begins digestion of starch -It breaks the food into small pieces to be easily swallowed b) Swallowing is the transport of food from mouth to stomach • It consists of 3 phases or steps; Steps of swallowing •Buccal Phase: Steps of swallowing •Pharyngeal Phase: Steps of swallowing •Oesophageal Phase: Motility of GIT 2. Motility of Esophagus • The esophagus prevents air from entering the GI tract through the function of the upper esophageal sphincter. • The esophagus prevents GI contents from re-entering the esophagus from the stomach through the function of the lower esophageal sphincter. • The contraction that sweeps down the esophagus (primary and secondary esophageal peristalsis) Motility of GIT 3. Motility of Stomach • The stomach is divided into proximal and distal areas. • Proximal area is thin walled, holds large volumes of food (to store food) because of receptive relaxation, and contracts weakly and infrequently. • Distal area is thick walled with strong and frequent contractions that mix and propel food into the duodenum. • Also, distal area is responsible for gastric emptying into duodenum Motility of GIT 3. Motility of stomach Gastric peristalsis Arrow showing partial liquid chyme pushed into duodenum via pylorus and more chyme pushed forth and back in stomach cavity being small pieces Motility of GIT 1 3 2 Motility of GIT 4. Motility of Small intestine • Motility of the small intestine serves four functions: - Mixing contents with enzymes and other secretions. - Further reduction in particle size. - Maximizing exposure of the contents to membranes of intestinal cells for absorption and digestion. - Propulsion of contents into the large intestine. • Two basic motility patterns exist: segmentation and peristalsis. Motility of GIT Segmentation movements and cutting 1 ~ 5 cm Motility of GIT Peristalsis Orad caudad Motility of GIT 5. Motility of Large intestine or colon • 2 basic motility patterns: a) Segmentation in the large intestine causes the contents to be continuously mixed b) Mass movement propels the contents of one segment of the large intestine into the next downstream segment. • Defecation involves involuntary reflexes and voluntary reflexes Secretory Functions (Secretions) of GIT Secretions of GIT • GI secretions function to lubricate (water and mucus), protect (mucus), sterilize (HCl), neutralize (HCO3-), and digest (enzymes). • Secretions arise from specialized cells lining the GI tract, the pancreas, liver and gallbladder. • The total volume of GIT secretions is about 6-8 L/day Secretions of GIT in Mouth Salivary Glands • Three pairs of glands • Parotid • Sublingual • Submandibular • Functions of saliva • Lubricates, cleanses oral cavity • Dissolves chemicals • Suppresses bacterial growth • Digest starch by amylase GIT secretions in Stomach Function of hydrochloric acid 1. Activating pepsinogen 2. Provide optimum for pH for action of pepsins 3. Food protein denaturation and easy decomposition; 4. Kill bacteria in food into the stomach 5. Promoting pancreatic, small intestinal and bile secretion 6. Helping Fe2+、Ca2+ absorption. Function of pepsins Function of pepsinogen protein HCl Pepsinogen Pepsin pH 2-3.5 peptone Function of mucous and intrinsic factor Mucus secretion • Soluble and insoluble mucus are secreted by cells of the stomach. • Soluble mucus mixes with the contents of the stomach and helps to lubricate chyme. • Insoluble mucus forms a protective barrier against the high acidity of the stomach content. Intrinsic Factor • Help absorption of vitamin B12 Pancreatic Secretion • Pancreas has 2 functions: a) Endocrine functions: secretes insulin and glucagon from islets of Langerhans b) Exocrine function: secretion of pancreatic juice • It has 2 components: aqueous and enzymatic components. • Aqueous component (contains HCO3) is important for neutralizing stomach acid in the duodenum so pancreatic enzymes can function properly • Enzymatic component is essential for the proper digestion and absorption of carbohydrates, fats, and proteins • Pancreatic enzymes include trypsin, chemotrypsin, lipase, and amylase Functions of pancreatic juice enzymes starch pancreatic amylase maltose + glucose pH 6.7-7.0 pancrelipase + colipase fat(Triglyceride) oil + monoglyceride + fatty acids pH 7.8-8.5 trypsinogen chymotrypsinogen Kinase, HCl, tissue fluid protein trypsin chymotrypsin polypeptide carboxypepti dase amino acid The Liver and Gall Bladder Functions of the Liver • Metabolic regulation • Store absorbed nutrients, vitamins • Release nutrients as needed • Hematological regulation • Plasma protein production • Remove old RBCs • Production of bile • Required for fat digestion and absorption Secretion of small intestine • Secretion from duodenal gland and intestinal gland • Secretory volume is 1~3L/day • It contains inorganic ion, mucoprotein, IgA, various enzyme, e.g. enterokinase ,etc • Function: • Protective effect by mucous • Digestion by enzymes such as peptidase, sucrase, lipase • Dilution Secretion of large intestine 1. colonic alkaline secretion to neutralize acids produced by intestinal bacteria 2. secretion of mucous for protection, lubrication of fecal matter 3. Vitamin B and K absorption made from bacterial flora in colon Digestion and Absorption Digestion and Absorption Digestion is a process essential for the conversion of food into a small and simple form. mechanical digestion by mastication and swallowing chemical digestion by enzymes Absorption is the process of transporting small molecules from the lumen of the gut into blood stream or lymphatic vessel. Digestion and Absorption Digestion and Absorption • Small intestine is primary site for digestion and absorption of food. • Digestion occurs in the GI lumen by secreted enzymes and on surface of enterocytes by membrane-bound enzymes. • Absorption occurs by simple diffusion, facilitated diffusion, active transport, endocytosis, and paracellular transport. • Surface area of small intestine is greatly increased by extensive folding and the projection of fingerlike villi covered with microvilli. Intestinal Villi Intestinal Villi Digestion of CHO (salivary and pancreatic) Absorption of CHO Enterocytes absorb glucose and galactose through an Nadependent secondary active transport process, while fructose is absorbed by facilitated transport. Digestion of proteins Absorption of proteins •The whole proteins by endocytosis •Amino acids and di and tripetides by Na-dependent 2ry active transport Lumen Endocytosis K+ Na+ Pump Exocytosis Digestion of fats Cholesterol esters Phospholipids Cholesterol ester hydrolase Phospholipase A2 Cholesterol Phosphate + Fatty acids Absorption Lipid digestion and absorption Large fatty molecule Lumen Intestinal Epithelia By effects of lipase, cholesterol ester hydrolase and phospholipase A2 Emulsification Fatty AcidsBile salts Cholesterol Monoglycerides Micelles The smooth endoplasmic reticulum Triglycerides Cholesterol esters Phospholipids In Golgi, they are packaged into Vessels Chylomicra (CM) or VLDL particles (On The Apoprotein B) chylomicra or very low density lipoprotein (VLDL) particles. Exocytosis Venous sysyem Absorption of Fats in the Small Intestine Lymph vessel THANKS